Cytologic aspect of fibrolamellar hepatocellular carcinoma in fine-needle aspirates

This is a review of the cytologic and clinicopathological findings seen in a series of six fibrolamellar hepatocellular carcinomas (FL-HCC) studied by means of fine-needle aspiration (FNA). ii comparison of several cellular m easurements (cell, nuclear and nucleolar sizes, and N/C ratios) of FL-HCC, ordinary hepatocellular carcinoma (O-HCC), and normal hepatocytes was also carried out in order to find out if these figures could be of help in the c ytologic diagnosis. Aspirates were made up of a rather monotonous populatio n of large discohesive cells resembling the morphology of the oncocytes see n in thyroid aspirates; trabecular arrange ment of tumor cells was not obse rved. Cytoplasmic pale bodies and hyaline cytoplasmic bodies were seen in v ariable quantities. Microbiopsies displaying the fibrolamellar pattern were observed in Sour cases. FL-HCC individual tumor cells were larger than ind ividual O-HCC tumor cells (P < 0.001), as were nuclear (P < 0.007) and nucl eolar sizes (P < 0.001), bur N/C ratio of O-HCC was higher than the N/C rat io of FL-HCC (P < 0.005), Based on the findings, a single cell aspirated fr om an FL-HCC is three times the size of a normal hepatocyte and 1.60 times the size of a single cell aspirated from a well-differentiated O-HCC. The c ytologic findings of FL-HCC are very characteristic and permit a correct di agnosis of this liver malignancy, provided the cytopathologist is aware of the clinical, demographic, CT-image, biochemical, and pathological features of this neoplasm. Diagn. Cytopathol. 21: 180-187, 1999. (C) 1999 Wiley-Lis s, Inc.